Screening for congenital hypothyroidism.
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Biomedical subjects
Publications and source records attributed to J A Hulse.
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Screening for hypothyroidism has been achieved by seeking raised concentrations of thyroid stimulating hormone (h-TSH) in dried blood samples collected on absorbent paper from some 1700 newborn babies each week using double antibody radioimmunoassay and 125I-label counting on a NE1600 gamma counter linked to a HP9815S desk top calculator. Specificity, accuracy, and quality control of the assay have been investigated. The calculator programme stores all count, time, and calculated data and uses log-log function formation and third-power homoscedastic polynomial fit to the calibration data followed, if necessary, by elimination of outliers set at P = 0.5%. Branching in the calculation procedure provides the ability to process sample data in subgroups, completely to reprocess data (including presentation in a form suitable for making a histogram plot), and to reset without loss of data in case of instrument or main power failure. Variance analysis was used to select the minimum duration of count (50 s), and it was demonstrated that homoscedasticity pertains in the regression calculation.
3 children with severe renal hypertension and bilateral infarction of the optic nerves are described. 1 patient also had a transverse myelopathy. Such complications may perhaps be prevented by earlier detection of hypertension and gradual reduction of blood-pressure.
Different measurements of thyroid function including I123 thyroid scanning were performed in 16 hypothyroid infants diagnosed by a TSH screening project. These results were then related to the clinical presentation and the bone age. Although T3 levels were preferentially maintained, it was the best single measure of the severity of hypothyroidism. Thyroglobulin may have a role in the diagnosis of athyrosis. Scanning showed that athyrosis was uncommon (12.5%) but an ectopic gland occurred in 40%, and accounts for many of the less severly affected cases found on screening. Some of these measurements may have prognostic significance.
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PRIMARY OBJECTIVES: The only reference centile curves currently available for body proportions of children in the UK were constructed more than 20 years ago by Tanner and Whitehouse. The current study was designed to produce up-to-date sitting height and subischial leg length centile curves for boys and girls in Southeast England. RESEARCH DESIGN AND METHODS: A convenience sample of 1424 boys and 1208 girls aged under 25 years from Southeast England was measured by a single observer in 1995-1996. Using Cole's LMS method, centile curves were constructed for sitting height and subischial leg length, and the medians by age and sex were then scaled to sum to the corresponding median height of the British 1990 reference. RESULTS: The new centile curves for boys and girls are presented. They differ significantly from those of Tanner and Whitehouse in leg length (boys p < 0.001; girls p < 0.01), but not in sitting height. CONCLUSIONS: The Tanner and Whitehouse reference curves for body segment length are not suitable for contemporary British children, whose legs are longer than they were a generation ago. It is proposed that the curves presented here be adopted provisionally as the new British reference.